Life as a Nephrology Professional

KDOQI CKD Guidelines 20th Anniversary

This podcast will celebrate the 20^th anniversary of the very first clinical practice guideline for CKD which included recommendations for CKD classification and staging. We are joined by Dr. Kerry Willis, Chief Scientific Officer of the NKF, Dr. Andy Levey Professor of Medicine at Tufts Medical Center and Joe Coresh, Professor of Epidemiology at Johns Hopkins School of Public Health and Mike Rocco, Chair of KDOQI and Professor of Medicine at Wake Forest Medical Center.   The original workgroup for the CKD guideline published in 2002 in AJKD was chaired by Dr. Andy Levey and Dr. Coresh from Johns Hopkins for the adult section of the guideline and by Dr. Rob Portman for the Pediatric portion. This guideline had a profound impact on the clinical care of both adults and children with kidney disease and it also was a major catalyst for CKD research. The published guideline was cited by 3,500 journal articles and now has over 20 accompanying editorials.  In 2012, the guideline was updated by the KDIGO and the classification stage was altered to include information on urine albumin excretion. But overall, the CKD staging system basically remains and in this podcast, we talk about how the guideline influenced clinical care, research and even policy.

Happy 40th Anniversary AJKD!

On this episode, our guests discuss how AJKD has pursued and met objectives over the past 40 years. Specifically, we will discuss how the AJKD has not only influenced the care of patients with kidney disease but helped NKF support its mission. We will discuss how AJKD helped to shape kidney disease research and clinical care and help grow patient centered care.

We are joined by four outstanding colleagues and speakers who will share their thoughts and experiences with AJKD and its impact on clinical care, research, education, and policy. 

Guests:

1. Kerry Willis-Chief Scientific Officer of the National Kidney Foundation 
2. Paul Palevsky, the current President of the National Kidney Foundation 
3. Sylvia Rosas, the president-elect of the NKF
4. Harold Feldman, Editor-in-Chief of AJKD

Other 40th Anniversary materials:

1. AJKD at 40: The Boston Era—Years 25-35 (2007-2016) Editorial by Daniel E. Weiner and Andrew S. Levey
2. Celebrating 4 Decades of AJKD Editorial by Harold I. Feldman, Jeffrey S. Berns, Laura M. Dember, and Nijsje M. Dorman
3. 40th Anniversary Special Collection: CKD 
4. 40^th Anniversary Special Collection: Kidney Transplantation
5. July 2021 Table of Contents
6. July 1981 Table of Contents
7. KDOQI Guidelines
8. A Unifying Approach for GFR Estimation: Recommendations of the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease

Removing Race from Kidney Disease Diagnosis

Over the past year and a half, the NKF and ASN have been leading the effort to develop race-free eGFR test results while maintaining the accuracy of the test. The NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Diseases has recently released its final report that recommends a new, race-free approach to estimate eGFR. In this collaborative episode with the ASN, the Task Force discusses how they approached the work and what efforts are being made to ensure the new equation is implemented as quickly as possible. Our guests, Dr. Cynthia Delgado, Dr. Lesley Inker, Dr. Joe Vassalotti and Tod Ibrahim discuss the goals of the Task Force and how the healthcare team came together to come up with a solution that better served kidney patients. They discuss the implications for patients, how clinicians and researchers can adopt these new guidelines, and what resources are available for both patients and the medical community to learn more.

 

Developed in accordance with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and recommended by the National Kidney Foundation and American Society of Nephrology Task Force Reassessing the Inclusion of Race in Diagnosing Kidney Diseases, the new app is available for free by visiting the NKF website. 

 

If you enjoyed this episode, please follow us on Apple Podcasts, Spotify, Podbean or wherever you listen to your podcasts. Have ideas for future episodes? Email us at nkfpodcast@kidney.org or tweet us @NKF_Nephpros. Thank you for tuning in!

 

COVID-19 Vaccine in Transplant Recipients with Dr. Dorry Segev

Dr. Dorry Segev has recently concluded multiple studies that looked at the immune response to COVID-19 vaccination in kidney transplant recipients. In this episode, Sam Kant (our new Life as a Nephrologist co-host) and Dorry Segev discuss these pivotal studies including the process, results, and directions going forward. Lastly, they discuss breakthrough infections.

 

List of study’s discussed:

• Immunogenicity of a Single Dose of SARS-CoV-2 Messenger RNA Vaccine in Solid Organ Transplant Recipients
• Antibody Response to 2-Dose SARS-CoV-2 mRNA Vaccine Series in Solid Organ Transplant Recipients
• Safety and Immunogenicity of a Third Dose of SARS-CoV-2 Vaccine in Solid Organ Transplant Recipients: A Case Series
• Risk of Breakthrough SARS-CoV-2 Infections in Adult Transplant Recipients

 

Dorry Segev, MD, PhD, is a Professor of Surgery and Epidemiology and Associate Vice Chair of Surgery at Johns Hopkins University. He has published over 650 peer-reviewed research articles, and is ranked #1 worldwide in organ transplantation expertise and influence by ExpertScape. Reflecting his contributions to health care, he was recently elected into the National Academy of Medicine. Reflecting the creativity and broad reach of his contributions, he received a prestigious Global Thinker Award from Foreign Policy Magazine and was named an Innovators of the Year by TIME Magazine. His work has directly influenced policy, including two Congressional bills (the Norwood Act for kidney exchange and the HOPE Act for HIV-to-HIV transplants), and is regularly featured in widely read media including several front-page features in the New York Times. In the context of the pandemic, Dr. Segev has shifted his research to better understanding coronavirus and its implications in solid organ transplantation.

 

We are bringing on a new co-host for this episode, please help us welcome Sam Kant, MD! He is a transplant nephrology fellow at Johns Hopkins University School of Medicine. He has completed nephrology fellowship at Johns Hopkins, internal medicine residency and chief residency at University of Maryland. His research interests include ANCA vasculitis, transplantation and has been a recipient of multiple awards in the realm of education. He is also the chair of the American College of Physicians Young Physician Council, co-editor of the Renal Fellow Network and editorial board member of American Society of Nephrology Kidney News. Additionally, he is a member of the planning committee for the 2022 NKF Spring Clinical Meetings. 

 

Critical Care Nephrology: Challenges and Opportunities

In this episode, we are discussing critical care nephrology, a dynamic and developing field which has seen an increase in popularity in the last decade. Our guests include a mix of junior and senior faculty, which is a testament to how this field is expanding.

Amanda Dijanic Zeidman and Michael Heung have recently authored the ACKD article “The Workforce in Critical Care Nephrology: Challenges and Opportunities”  which is the topic of this episode’s discussion. They are also joined by Jay Koyner and Javier Neyra (critical care nephrologists) and Matthew Broyles a critical care anesthesiologist.

They discuss their journeys to critical care, why anesthesiologists or nephrologists might be interested in critical care, pros of receiving critical care training, how anesthesiology has supported this subspecialty, how to support nephrologists that are interested in critical care and more! They wrap up with resources, communities, and courses for trainees and nephrologists interested in critical care. Listen in to this discussion from this great community with diverse backgrounds!

 

Follow them on Twitter!

Javier: @jav_neyra

Amanda: @AmandaDZeidman

Michael: @keepingitrenal

Jay: @jaykoyner

 

Providers and their LGBTQ+ patients – the importance of creating an affirming environment

For many in the LGBTQ+ community, fear of discrimination and harassment can get in the way of seeking medical care when they are sick and can put them at increased risk of serious health problems, including kidney disease. In this episode, we discussed how to create an inclusive and affirming environment in a healthcare setting for LGBTQ+ patients such as how a provider earns trust, what qualities a gender affirming provider has, understanding patient’s identities, how you can make your dialysis units more comfortable for LGBTQ+  patients, and how HCPs can participate in advocacy. Our speakers are Dr. Dinushika Mohottige and Dr. Mitchell R. Lunn, two experts in sexual and gender minority health, as well as living kidney donor and the first openly gay elected state legislator in Pennsylvania history, Rep. Brian Sims.

In this episode, you will hear from:

Dinushika Mohottige, MD, MPH:

Dr. Mohottige is a Nephrologist and Medical Instructor in the Division of Nephrology at Duke University Hospitals. She received a B.A. in Public Policy and a Health Policy Certificate from Duke University in 2006, where she was a Robertson Scholar. She then earned an MPH in Health Behavior/Health Education from the UNC Gillings School of Global Public Health and a medical degree from the University of North Carolina at Chapel Hill School of Medicine, followed by Internal Medicine and Nephrology training at Duke University. She now works under the mentorship of Dr. Ebony Boulware and Dr. Clarissa Diamantidis to engage in patient and community-centered, inequity-focused research around the impact of socio-structural factors on kidney health and kidney transplantation.

 

Mitchell R. Lunn, MD, MAS, FACP, FASN:

Dr. Lunn is an Assistant Professor in the Division of Nephrology of the Department of Medicine at Stanford University School of Medicine. As an internist and nephrologist with a strong interest in technology and sexual and gender minority health, Mitch’s research is designed to characterize the health and well-being of these populations. Mitch is the co-director of PRIDEnet, a participant-powered research network of SGM people that engages SGM communities at all stages of the biomedical research process: research question generation and prioritization, study design, recruitment, participation, data analysis, and results dissemination. He currently serves on the American Society of Nephrology’s Diversity and Inclusion Committee.

 

PA State Representative Brian Sims:

Brian Sims is a member of the Pennsylvania House of Representatives in the 182nd district. Elected in 2012, Sims is also a lawyer and activist on LGBTQ+ civil rights. Sims is the first openly gay elected state legislator in Pennsylvania history. In January of 2020, he donated his kidney to his friend. He has been vocal about supporting organ and tissue donation. Currently, he is a candidate for Lieutenant Governor of Pennsylvania in the 2022 election.

The NKF Patient Network

After almost two years of collaboration with volunteer advisory committees—comprised of nephrologists, patient advocates, and researchers in academia and the private sector—the NKF Patient Network is live!

On this episode of Life as a Nephrologist, we are joined by Kerry Willis, Lesley Inker, Alexander Chang, Cari Maxwell and Curtis Warfield. Our guests begin the episode by explaining how the patient network journey started and the purpose of creating it. It is the only kidney disease registry that has both patient-entered data and electronic medical records for patients with all stages of kidney disease. By joining the network, patients will not only help build this important data set, but they will have access to on-going clinical trials; health tips; individualized patient education for their specific stage of the disease; and a community of other patients.

The user friendly and secure Network collects both rigorous clinical and laboratory data from electronic health records (EHR), in addition to patient-entered data, which together allow for a complete picture of the patient experience. This model is innovative in that most research initiatives follow one path or the other—EHR or patient self-reporting. The NKF Patient Network will compile data on demographics, medical history, lifestyle, medications, blood and urine test results, in addition to extensive data on patient perceptions, challenges, and priorities. Overall, this network will allow patients to grow their voice, be transparent about their struggles and advocate for themselves. 

 

 

Palliative Care and Nephrology with Dr. Holly Koncicki

On this episode, Corey is joined by our guest, Holly M. Koncicki, Associate Professor of Nephrology and Palliative Care at Mount Sinai. Dr. Koncicki is in the Division of Nephrology and Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai.

First, Dr. Koncicki discusses what inspired her to become a nephrologist and how she became interested in palliative care. Corey and Dr. Koncicki review data from To Dialysis and Beyond: The Nephrologist’s Responsibility for Advance Care Planning. She offers advice on decisions about modality for advance kidney disease patients and dialysis. She notes how is it not only important to work well with the interdisciplinary team, but it’s crucial to coordinate with the patient’s other providers, such as their cardiologist, oncologists, etc. The conversation about the patient’s care needs to continue overtime and the care team must be on the same page in order to make it less difficult for the patient.

In relation to advanced care planning and dialysis, they talk about over discussing and reflecting on conversations to match patient values.

They expand upon dialysis versus conservative management:

How do you objectively tell your patients they would not do well on dialysis?

How do we assess who is at a high risk of having poor outcomes on dialysis?

How do we get doctors to think about conservative kidney management?

They wrap up by discussing Dr. Koncicki’s AJKD article Opioid Management in CKD and how doctors should appropriately select opioids as well as the importance of setting expectations for patients.

 

 

Get Involved with our Kidney Outreach Team

The National Kidney Foundation's Kidney Outreach Team is a growing group of professionals and community leaders who use their experiences and expertise to inform elected officials and other key decision makers on kidney-related legislation, policies, research, programs and education.  

We need YOU to make better kidney policy possible. To find out more information or get involved go to https://www.kidney.org/advocacy/advocate or email nkfadvocacy@kidney.org

 

Women in Nephrology

The faces of leadership in nephrology are changing, what was once a playing field for exclusively men, is slowly transforming to include a diverse group of men and women.  

In this episode, we are joined by women who have traversed the leadership ladder. This group includes a current President, two incoming presidents of nephrology societies and an industry executive:   

Dr. Holly Kramer, National Kidney Foundation President, clinical nephrologist at Loyola University Medical Center

Dr Lisa Curtis Associate Professor of Medicine at UAB and incoming Women in Nephrology President

Dr. Susan Quaggin, Canadian nephrologist and incoming American Society of Nephrology President

Dr. Reshma Kewalramani, CEO and President of Vertex Pharmaceuticals

These women discuss their journeys, the importance of mentorship, taking risks, kindness, and keeping prospective. Also, they talk about finding your purpose, perseverance, and how to bounce back from failure and rejection. We hope you enjoy this episode with significant insights and advice from each guest. Please share this episode and let us know your thoughts on Twitter @NKF_NephPros or email nkfpodcast@kidney.org

Episode 20: International Medical Graduates in Nephrology: A Guide for Trainees and Programs

In this episode, we discuss the recently published ACKD article, “International Medical Graduates in Nephrology: A Guide for Trainees and Programs” Our guests are the authors, Javier Neyra, Maria Clarissa Tio, Silvia Ferrè and the co-editors Matthew Sparks and Samira Farouk.

 

Although international medical graduates are offered opportunities for training and professional growth that are beyond those available in their countries of origin, they typically encounter barriers to transition from training to practice and early-stage career development. The authors describe the exchange visitor and temporary worker visas granted to foreign trainees in the U.S, focusing on the transition from training to nephrology practice and/or research. They provide recommendations and encourage trainees to seek continuous support from their programs/sponsors and assistance from immigration representatives at their training institutions. This episode provides a positive message that there are many pathways to arrive at the desired post-training destination and emphasizes how additional funding opportunities are there! Ultimately, these authors will not let you navigate blindly.

 

We are bringing on a new co-host for this month’s episode, please help us welcome Natasha Dave, MD! She is a nephrologist at the Bruce W. Carter Miami Veterans Affair Medical Center. She completed her internal medicine residency training at Mount Sinai Hospital in Chicago and then completed her Nephrology fellowship and chief year at Baylor in Houston. Post-fellowship she joined Baylor as an assistant professor of medicine primarily practicing at the Michael E. DeBakey VA Medical Center prior to moving to Miami.

Dr. Dave's other clinical and educational interests include mentorship, social media/educational content generation and as her Twitter profile (@NatashaNDave) suggests electrolytes. She serves on the Executive Council of Women in Nephrology and is involved in a number of online projects and roles that begin after she completed a one year social media internship with the Nephrology Social Media Collective (NSMC). Some of these roles include being a faculty contributor for the Renal Fellow Network and American Journal of Kidney Diseases blogs as well as partaking in committees with the American Society of Nephrology, Nephrology Business Leadership University, Kidney Medicine journal and NSMC. Outside of medicine her other passions include long distance running, meditation and travel.